Thursday, February 11, 2016

Women and HIV

    According to the Center for HIV Law and Policy, women living with HIV statistically tend to be poor and women of color.  These and other women living with HIV, face multiple societal and cultural barriers, and are further stigmatized because of their HIV status.  Women face barriers that men with HIV do not.

    The interplay of the triple stigma is no more evident than in family court.  At least one half of women living with HIV report being in or having been in an abusive relationship.  They experience partners controlling their medication. In some cases, their HIV positive partners consume the medication rather then seek medical help on their own.  Women who seek civil protection orders must consider the likelihood of the partner's "outing" their medical condition in open court or through public documents.  Often women choose not to reveal their HIV status, trading critical  testimony for either privacy or the abusive partner's silence.  Jane Stover addressed the difficulties of HIV positive battered women in her article Stories Absent from the Courtroom: Responding to Domestic Violence in the context of HIV-AIDS.  But not all of the legal challenges originate with  abusers. 

    Mothers living with HIV face challenges in custody matters that HIV positive fathers do not.   When women are infected, particularly women of color, courts are concerned with the cause of infection.  Consistent with the cultural expectation of the "perfect mother", presumptions are made around women's sexuality, including promiscuity and sex work.  Reproductive rights can be impinged by physicians not understanding that for medically treated mothers, transmission between mother and fetus is nearly impossible. 

    Women also can be encouraged to take PrEP, the relatively new medication that has proven effective in preventing transmission.  But the drug's  testing was done largely with the men who have sex with men.  The research leaves unanswered questions of how the drug will impact women's hormonal systems as well as bone density.  Little has been done to ensure the safety of children breastfeeding from mothers who take PrEP.  And transgender women need studies separate from other women. 

       Two organizations that focus exclusively on the needs of women living with HIV are creating change.  Positive Women's Network has  conducted research on the barriers faced by HIV positive women and SisterLove assists women living with HIV in resolving their health care challenges, including reproductive health.  The greatest health care challenge may be how to make health care and research systems gender inclusive when addressing solutions for those living with HIV.

 

February 11, 2016 in Health, Margaret Drew | Permalink | Comments (0)

Wednesday, February 10, 2016

Criminalization of HIV: A Human Rights Call for Science Based Laws

This is the first in a series of posts addressing the status of those in the US living with HIV/AIDS.

To varying degrees of culpability, over thirty states in the nation have laws criminalizing having sex while HIV positive.     States vary from treating HIV the same as exposing a partner to any STI to intentional infection of a sexual partner.  Many of the statutes are based upon outdated science.

Most criminalization statutes originated during the hysteria of the 1980's when thousands, primarily gay men, died of the virus because no stabilizing or preventive medication had been developed.  The treatment world has changed.  And while a few states amended or invalidated laws designed to punish those living with HIV for having sex without disclosing their status, overall the U.S. has done very little to update laws to reflect the limited likelihood of transmission.

No longer is HIV a terminal condition.  Contemporary treatments are effective not only in extending life within normal range, but in prohibiting transmission.  Viral loads can be undetectable, making transmission impossible. Aids.gov states that HIV cannot be transmitted through saliva.  There is no known case of HIV transmission through spitting, yet many states enhance punishment for those who are HIV positive and spit on a police officer. Bad science makes bad laws. 

 In 2008, a man in Iowa, Nick Rhoades. was sentenced to 25 years after a one time sexual encounter during which he used a condom but did not disclose his positive status. His viral load was undetectable.  After spending over five years in jail, his sentence was reduced to time served after Lambda Legal successfully assumed representation.  Prison release happened only after Rhoades spent six weeks in solitary confinement, a traumatizing experience all its own.

While HIV is treatable, this does not diminish anguish felt by those who have been infected through a non-disclosing sexual partner. But the penalty for transmission, even intentional, is often as great or greater for crimes of where the victims are killed. The most recent conviction took place in Missouri last year.  Twenty-three year old Michael Johnson was prosecuted for knowingly exposing sexual partners to HIV.  Only one of the partners  contracted HIV due to the encounter with Johnson.  Johnson was sentenced to over 30 years in prison, a sentence far longer than most manslaughter sentences.  

According to the Center for HIV Law and Policy  nearly two hundred HIV prosecutions have occurred since 2008.  

The Global Network of People Living with HIV calls the US one of the world's hotspots for HIV criminalization.

 

 

February 10, 2016 in Health, Margaret Drew | Permalink | Comments (0)

Tuesday, December 8, 2015

Abortion Providers Are Human Rights Defenders

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By Cynthia Soohoo 

Has anti-choice propaganda led to an increase in violence and attacks on abortion clinics?  Following last week’s tragic attack on the Colorado Springs Planned Parenthood, the news has focused on the impact of videos released by the Center for Medical Progress and political rhetoric targeting Planned Parenthood.  Meanwhile, the New York Times and Washington Post have published pieces trying to figure out what motivated Robert Dear, Jr. 

But, regardless of how the media depicts this latest act of violence, it’s clear that there’s a long and well-documented history of attacks on abortion clinics and providers.   The Colorado shooting should remind us of the dedication and bravery of abortion providers who daily face intimidation, threats and harassment designed to prevent women from accessing health services and rob them of their right to make their own reproductive rights decisions.  For their work, abortion providers are often stigmatized, but they should be acknowledged as human rights defenders.

In an op ed in the New York Times, Dr. Willie Parker describes how he gave up his OB practice in Chicago and moved to Alabama to provide abortions full-time.  He explains “[i]n public health, you go where the crisis is. If there is an outbreak and you have the ability to relieve suffering, you rush to the site of the need. This is why, a year and a half ago, I returned to my hometown, Birmingham, Ala., to provide abortions.” 

Despite physical threats and threats to their livelihood, abortion providers remain committed to providing care to women.  A recent article in Rolling Stone profiled a doctor who was bombarded with harassing calls and “veiled threats online (‘I wonder if someone will shoot the new provider...’).”  She eventually gave up her family medicine practice after anti-choice activists picketed her practice and pressured the building where the practice was located. “I wasn't about to let awful tactics like that work, because that would just encourage them to keep doing that to others. So the ultimate effect was that I became a full-time provider of abortion care.” 

Mother Jones describes the heroic efforts of abortion providers to keep clinics open in the face of new and frequently arbitrary requirements and regulations imposed on them by anti-choice legislatures each year.  And Pro Publica describes the constant barrage of personalized harassment providers face, including picketing of private homes and the targeting of families for harassment.  To avoid harassment and threats of violence, providers register their homes in their spouses’ names; they change their path to work; they buy bullet-proof vests.  All to ensure that women are able to make their own reproductive health decisions.

The international community has recognized that medial and health services professionals are human rights defenders when they provide services to ensure that women can exercise their reproductive health rights.  In 2010 the Special Rapporteur on Human Rights Defenders, a U.N. human rights expert who monitors and speaks out about attacks on human rights defenders, stated that “[i]n certain countries . . .  health professionals, as a result of their work, are regularly targeted and suffer harassment, intimidation and physical violence.” The report recognizes that attacks have led to “killings and attempted killings of medical professionals.”

Last month, the Special Rapporteur on Human Rights Defenders, joined by five other human rights experts, issued a statement emphasizing the need to protect sexual and reproductive rights defenders in the Americas.  The statement recognized that sexual and reproductive rights defenders “face the same risks as many other activists, but they are further exposed to retaliation and violence because they challenge power structures based on patriarchy and deeply-held gender stereotypes about the role of women in society.”

For their commitment to women’s rights and the challenges that they face to provide services, abortion providers should be recognized as human rights defenders.  Let’s change the dialogue and recognize them as the heroes they are.

December 8, 2015 in Cindy Soohoo, Health, Reproductive Rights, Women's Rights | Permalink | Comments (0)

Wednesday, October 14, 2015

'Poderosas' Seek Salud, Dignidad and Justicia

by Cynthia Soohoo

Last week, the Nuestro Texas campaign—a joint project of the Center for Reproductive Rights and the National Latina Institute for Reproductive Health—issued a report documenting a women’s human rights hearing held last March in the Rio Grande Valley.  Lately, Texas has made front-page headlines because a challenge to HB 2 a Texas abortion statute is making its way to the Supreme Court.  Abortion access was very much an issue at the hearing, but the testimony made it clear that the human rights problems in the Valley are much broader and deeper.

I served as an expert, along with 6 other human rights experts from the U.S. and Mexico for the hearing.  In addition to attending a community meeting in a colonia (an unincorporated area that lacks paved roads and other infrastructure) and touring the last remaining abortion clinic, the experts listened to a full day of women’s testimony.  The testimony illustrated multiple human rights issues, including the historic lack of health care infrastructure and affordable services for poor and rural women, the profound barriers that immigrants face in accessing health care in Texas, and the impact of recent Texas laws and policies that have gutted family planning services through cuts in funding and the exclusion of Planned Parenthood from receiving state funds for preventive care.  (Although the funding was reinstated during the most recent session of the Texas legislature, the facilities that served women in poor and rural communities—dozens of clinics across the state that were forced to close or severely cut back on services—will not receive this new funding).  

During the hearing, women shared stories about being turned away from clinics that did not have appointments available or funding only to later learn they had cancer.   They described fears about their families’ future as they live with the uncertainty of undiagnosed breast lumps.  They described the lack of available and affordable family planning, and the difficulties that an unplanned pregnancy creates for a mother struggling to care for her family or a woman trying to pursue her education.  

 The women who took part in the hearing also conveyed their vision for Texas’s future, and their commitment to fight for change. As Lucy Felix, field coordinator for the Texas Latina Advocacy Network stated, “We are all fighting together for a different Texas—a just Texas. What we want is a Texas with human rights for all.”

 

October 14, 2015 in Cindy Soohoo, Health, Women's Rights | Permalink | Comments (0)

Friday, July 31, 2015

USHRN Takes the Right to Water and Sanitation to a Human Rights Tribunal

The critical need for affordable, fresh drinking water has been the subject of several posts on this blog.  Now the US Human Rights Network announced that on July 28th it, along with twenty other organizations and individuals, requested a hearing with the Inter-American Commission on Human Rights on the right to safe drinking water and sanitation in the U.S.

Among concerns, the letter requesting a hearing addressing water shutoffs in Detroit, Baltimore and Boston.  The letter addresses concerns around contamination and lack of sanitation in rural areas as well, namely the San Joaquin and Salinas Valleys of California along with the Black Belt of Alabama.  The disparate impact on African Americans and Indigenous peoples is documented for the Commission.

Rebecca Landy of the USHRN is the point of contact for the Commission.  We look forward to her periodic updates on this important development.

Watch for more information on Northeastern Law's conference "Tapping into the Human Right for Water", being held on November 5 and 6. 

 

 

 

July 31, 2015 in Advocacy, Health, Indigenous People, Water | Permalink | Comments (0)

Thursday, June 25, 2015

Health Care: Here to Stay

by Wendy Parmet, Northeastern University School of Law, guest contributor

With Chief Justice Roberts' remarkably strong decision today for the Supreme Court in King v. Burwell millions of Americans can now rest assured:  affordable health insurance is here to stay.  There may not be a constitutional right to health care in the U.S., and thanks to the Court’s 2012 decision regarding the Affordable Care Act’s Medicaid expansion, millions of citizens (not to mention non-citizens) remain uninsured; but the ACA’s promise of providing affordable coverage to millions of low income Americans is now secure.

The question before the Court in Burwell was whether individuals in the 34 states that rely on a federally-operated health insurance exchange, rather than a state-created exchange, are eligible for the federal tax credits. Without those credits, most people could not afford to buy insurance on the exchanges. Nor would they be subject to the ACA’s mandate to have coverage. As the Court recognized, as healthy people fled the exchanges, the insurance markets in states with federally-operated exchanges would experience a death spiral.

The challengers’ arguments were simple, if disingenuous. The provision in the ACA that calculates the amount of credits to which an individual is entitled is based in part on the period of time in which the individual is enrolled in a plan “through an Exchange established by the State.” According to the challengers and the dissenting justices, those words make it clear that tax credits are limited to individuals who purchase insurance through state-created exchanges. Conceding that their interpretation would effectively kill the exchanges in the 34 states that rely on a federal exchange, the challengers concocted the theory that Congress inserted a poison pill into the ACA to push states to create their own exchanges. 

Fortunately for millions of Americans, 6 members of the Court disagreed. What is remarkable about the Court’s opinion, however, is not its conclusion. The challengers’ case was weak from the get-go. What’s most notable is the way the Court reached its conclusion.

The Obama Administration and supporting amici curiae offered the Court three different paths to saving the ACA. One was based on so-called Chevron deference. This holds that when statutes are not clear, courts should defer to the administrative agencies which interpret them, in this case the Internal Revenue Agency which had ruled that tax credits were available to individuals who purchase insurance through federally-created exchanges. If the Court had followed this path, the ACA would have lived for another day, but a future Administration could have reversed course. This can’t happen now because Chief Justice Roberts’ opinion expressly rejected Chevron deference, finding that the statute is not ambiguous. The statute, he determined, requires that subsidies be made available to people who buy insurance on a federally-created exchange.

 A second path to upholding the statute was hinted at by Justice Kennedy during oral arguments when he asked whether the challengers’ interpretation of the Act would unconstitutionally coerce the states. Many commentators thought that Court might rely on that reasoning and construe the statute in the Obama Administration’s favor, while expressly stating it did so to prevent unconstitutional coercion of the states. Such an approach would have saved the ACA, but it might have planted new constitutional doubts about the scope of federal authority.

 The third approach, and the one adopted by the Court, was to interpret the ACA as requiring that subsidies be available to people purchasing insurance on federally-established exchanges. The Court reached this conclusion by refusing to read the words “established by the State” out-of-context. Instead, the Court recognized that the interpretation offered by the challengers simply made no sense in light of the ACA taken as whole. Congress did not allow for federally-created exchanges only to make them collapse. When all of the provisions of the ACA are read together, the majority insisted, the meaning of the disputed words is crystal clear. Exchanges established by the state are exchanges created under the Act for a state, regardless of whether they are operated by the federal government or the states.

With that simple but declarative ruling, the Supreme Court provided the most decisive victory possible for the ACA, and for Americans who need health care.  The statute is clear. Subsidies cannot be withdrawn by a future Administration. Nor are there any new constitutional concerns. Although some politicians will continue to insist otherwise, the existential debates over the ACA may finally be laid to rest; and so millions of Americans can rest easily.

 

June 25, 2015 in Health | Permalink | Comments (0)

Monday, May 18, 2015

The Criminalization of HIV

The trial of Michael Johnson in Missouri has been watched by those living with HIV and their advocates.  Johnson, 23, was charged with one count of recklessly infecting a person with HIV, one count of attempting to recklessly infecting a person with HIV and three counts of recklessly exposing partners to HIV.  It is impossible to separate racism and homophobia from other motivations in the prosecution.

According to a statement issued by Aids United,  Johnson is African American and his accusers are white.  Only one of the 12 jurors was African American.  The vast majority of jury pool members believed homosexuality is a sin.  Half the jury pool believed that homosexuality is a choice.

Even more troubling were prosecution witnesses who called witnesses who referred to HIV as terminal.  Thirty states have laws criminalizing exposure behavior.  "Most states have not updated their laws to reflect our modern understanding of the effectiveness of today’s antiretroviral therapies and prevention strategies like consistent condom usage and pre-exposure prophylaxis (PrEP)"  Some states have laws criminalizing spitting and scratching even though there is no evidence that either action is a method of infection.

Catherine Hansenns is Executive Director of The Center for HIV Law and Policy and has spoken extensively on the criminalization of HIV.  In response to the verdict, which could carry a decades long sentence, she said:  "Michael Johnson's conviction for exposing one of his sex partners to HIV and attempting to expose four others... reinforces public hysteria and misconceptions about HIV."  Hansenns points out that those with human papilloma virus are not held to this criminal standard even though the virus is known cause cancers. 

Dr. Wendy Armstrong of Emory University School of medicine noted that “HIV is no longer a death sentence. Like herpes, it is an incurable but treatable viral infection. With treatment, a person living with HIV will in all likelihood live a normal life span.”

Criminalization raises issues of autonomy.  Absent an abusive relationship, each partner is determined to make his or her own choices around sex, including safe sex.  American discomfort with sex as well as the refusal to accept science is implicated as well.  But more concerning is that criminalization is punitive without regard to consequences. Fewer individuals are likely to be tested.  Without knowledge, one cannot be criminally charged. 

 

 

May 18, 2015 in Health, Margaret Drew, Sexuality | Permalink | Comments (0)

Wednesday, April 1, 2015

The Human Right To Die?

by Lesley Wexler

With high profile death of cancer patient Brittany Maynard who argued for the right to die; the touching account of Dr. Paul Kalinithi on how to continue life in face of an imminent death; and most recently, the Atlantic’s article on rising support for legalizing the doctor’s role in assisted suicide, I am wondering whether the so called right to die and attendant rights like those of physicians to assist might be productively cast as a human right.

While domestic legal fights have focused on constitutional issues and statutory prohibitions and protections, the questions underpinning a right to die might also be addressed by foundational principles in International Human Rights Law.  As Jordan Paust’s thoughtful essay on this topic points out, International Human Rights Law recognizes the “general, fundamental, and enduring right of each person to human dignity” along with rights to privacy and liberty all of which are implicated by the right to die.  The right to be free from torture, cruel, inhuman or degrading treatment, and the right to effective social and medical assistance might be implicated in individual cases as well.

Given the sensitive issues at stake and the polarized options, the right to death is hardly low hanging fruit for an international human rights movement and I wouldn’t expect this to emerge as a UN human rights treaty any time soon. But there may be advantages to framing this issue within a human rights narrative.

In so doing, I think domestic advocates need to think about whether it is worthwhile to compare those denied the means to control the timing and nature of their death to others who suffer violations of their human rights. Similarly, would it make sense to connect the stories of terminally and chronically ill patients who seek to make end of life decisions to hunger strikers and other political activists who use their health and the risk of death to express a political opinion? Should right to die advocates seek to find connections between poster child Brittany Maynard and hunger striker Shaker Aamer; between doctors that want to assist ALS patients and members of the military who refuse to force feed Guantanamo hunger strikers?

I think asking such questions now, when the issue is so salient, might be productive in thinking about how to generate wider acceptance of this social movement. I believe that human rights language and thinking can help inform this debate even if it doesn't directly shape much of the legal landscape. But these are just some early thoughts, so I welcome comments and suggestions.

 

April 1, 2015 in Health, Lesley Wexler | Permalink | Comments (0)

Thursday, March 5, 2015

King v. Burwell, Human Rights and the Four Words

Yesterday's Supreme Court argument in King v. Burwell focused on the interpretation of just four words -- "established by the state" -- buried in the mega-statute that is the Affordable Care Act (ACA).   Hanging on the Court's interpretation of this phrase is whether people in states where the federal government runs the health insurance marketplaces are eligible for subsidies that help them afford insurance. In short, the fate of the ACA -- and the health of millions -- is at stake.

While statutory interpretation seems like a quintessential issue for purely domestic legal analysis, it's worth remembering that U.S. health policy is scrutinized on the international stage as well as at home.  This May, the U.S. will send a delegation to Geneva to participate in the Universal Periodic Review (UPR) of U.S. compliance with human rights obligations.  In its February 6 , 2015,  UPR submission, the U.S. touted the positive impacts of the ACA from a human rights perspective, as follows:

    100. The United States has undertaken many initiatives domestically to promote food security     and expand health care. The Affordable Care Act has increased health coverage options and     quality through new consumer protections, the creation of the Health Insurance Marketplaces—a     new means for uninsured people to enroll in health coverage—and additional support for state     Medicaid and Children’s Health Insurance Programs. It requires most health plans to cover ten     categories of essential health benefits, including preventive services, maternity and prenatal care,     hospitalizations, and mental health and substance use disorder services. It also reauthorized the     Indian Healthcare Improvement Act, to address some of the health care access concerns in     indigenous communities.

    101. We are committed to expanding access to health care to all our citizens and as such, have         made efforts to strengthen and protect our social and health care programs: Medicare for the     elderly and disabled, and Medicaid for low-income individuals and families. Under the ACA,     Medicare beneficiaries have saved billions of dollars on prescription drugs and have seen no     increase in rates since 2013. Additionally, Medicare beneficiaries no longer have to pay cost-            sharing for preventive services, and nearly nine million individuals have enrolled in coverage in     state-run Medicaid programs since October 2013.

This submission follows the federal government's many other representations in international fora concerning the benefits of the ACA -- a litany that was set out in a human rights amicus brief filed in the original Supreme Court ACA case. 

While it certainly is not the gold standard of universal health care, the ACA at least represents a step toward progressive realization of the right to health in the U.S., and provides a response to international critics of the U.S. record on economic and social rights.  A crabbed reading of the four words at issue in Burwell v. King will harm millions and set back the cause of more comprehensive health care; it will also expose the U.S. to international criticism, undermine U.S. ability to credibly critique other nations for their ESC rights violations, and hamper U.S. leadership efforts on ESC rights.  It is hard to believe that was the drafters' intent in 2010.

 

 

March 5, 2015 in Health | Permalink | Comments (0)

Monday, February 23, 2015

Health Journals Seek Human Rights Submissions

Two health-related journals are seeking submissions addressing human rights issues.  First, the influential Journal of the American Medical Association (JAMA) is planning a 2015 theme issue on trauma associated with violence and human rights.  For the issue, which will be published in August 2015, JAMA is soliciting papers on trauma resulting from unintentional and intentional injury, from interpersonal and community-levels of violence, and from mass conflict, war, displacement, and natural disasters.

According to the JAMA announcement, "[a]uthors may submit manuscripts addressing any topic related to trauma, injury, violence, war, civil conflict, disaster, and human rights abuses. We are particularly interested in manuscripts reporting on studies of interventions to address the effects of trauma, new modes of management and treatment, and optimal systems of care in a variety of settings. Randomized clinical trials of preventive, therapeutic, or rehabilitative interventions are of primary interest, but we will also consider reports of observational studies and systematic reviews that address new and important findings as well as scholarly Viewpoints that address timely topics on clinical management, research, and policy related to trauma, violence, or human rights."

Manuscripts received by March 15, 2015, will have the best chance of consideration for publication in the JAMA theme issue. More information about submission procedures is here

Second, the open access Health and Human Rights Journal, edited by Dr. Paul Farmer and Carmel Williams, is soliciting submissions for its special issue on Tuberculosis and human rights.  According to the call for papers, TB and human rights is a neglected topic.  Possible subjects to be addressed in the special issue, slated for June 2016, are: 

    -- The individual rights and entitlements of people living with and vulnerable to TB;

    -- The obligations of States and non-state actors under human rights law to respect, protect and fulfill rights, including through prevention measures, and diagnosis and treatment;

    -- The role of human rights in promoting the availability, accessibility and acceptability of good quality testing and treatment for TB;

    -- The impact of stigma and discrimination in the lives of people living with and vulnerable to TB;

    -- The situation of key affected populations;

      --The State’s duty to protect against violations of human rights by non-state actors, such as pharmaceutical companies and private health providers.

Submissions should be received by September 20, 2015.  Guidelines for submission are here.

 

February 23, 2015 in Health, Scholarship | Permalink | Comments (0)

Thursday, February 5, 2015

Vaccinations and Human Rights, American Style

With the outbreak of measles in the U.S., traceable to unvaccinated Disneyland visitors, the "anti-vaccine" movement has gained new attention.  A survey of anti-vaccine websites and blogs indicates that one of the arguments frequently made by defenders of the movement is that refusing vaccines is a human rights issue.

But while many can appreciate that mandating vaccinations against a patient's will can raise medical ethics concerns regarding patient decisionmaking and autonomy, the human rights issues seem to cut in the other direction.  

It is worth remembering that the movement to refuse vaccines is a phenomenon largely limited to those places where people are fairly certain that the medical infrastructure in place ensures that they will not actually get the serious diseases (e.g., mumps, measles, rubella) that the vaccinations address.  In contrast, in most parts of the world, where measles alone threatens more than twenty million people each year, it is access to health- and life-saving vaccinations that is the human rights issue.   For example, a General Comment recently issued by the UN Committee on the Rights of the Child emphasized the affirmative government obligation to ensure that the benefits of immunizations reach "all children who need them."  Similarly, the UN Social Forum to be held in Geneva later this month will focus on "access to medicines in the context of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health."

Researchers at the World Health Organization, balancing the individual right to refuse vaccines with the collective right to health, have concluded that:    

  "Parent's refusal to get vaccinated or to vaccinate their children can cause collective harm by       incrementing the pool of unprotected, susceptible individuals in a community.  With herd       immunity compromised, devastating disease outbreaks can occur.  In these settings, individuals       are morally obligated to accept vaccination to prevent harm to others."

Some experts, sensitive to individual autonomy issues, have suggested that governments should comply with their health-related obligations through education and encouragement -- i.e., "nudges" -- rather than attaching punishment to vaccination refusal.  If "nudges" are as, or more, effective than other approaches, then this would certainly be an appropriate route.  

Whatever mechanism a government adopts for promoting vaccination, however, it is clear that the weight of the human right arguments fall on the side of promoting the right to health.  The right to refuse vaccine may be compelling when considered in isolation, but people who refuse vaccines do not do so in isolation, and the collective human right to health prevails.  

February 5, 2015 in Health, Martha F. Davis | Permalink | Comments (0)

Wednesday, January 14, 2015

Menstrual Health and Human Rights -- Yes, That's Right

 

Among the milestones of the past year was the first ever Menstrual Hygiene Day on May 28, 2014.  As a step toward bringing menstrual health out of the shadows, the global day was a great success, triggering blogsop eds and other acknowledgments of the role that the menstrual cycle plays in the lives of women and girls. As Gloria Steinem famously wrote in her spot-on Ms. Magazine essay, "If Men Could Menstruate" the social status of menstruation would be different -- and longer and more would be something to brag about!  But instead, menstruation is an obstacle to girls education and women's employment, and women everywhere understand that their dignity is undermined when menstruation is treated as shameful.  No wonder that Elena Kagan, now a U.S. Supreme Court Justice, made headlines -- and won fans among female law students -- when one of her first acts as the new Harvard Law School Dean was to acknowledge the reality of menstruating students by providing free tampons in the women's bathrooms.

Now, the Society for Menstrual  Cycle Research has announced a major conference, June 4-6, 2015, in Boston:  Menstrual Health and Reproductive Justice: Human Rights Across the Lifespan.  With human rights activist Loretta Ross as the keynote speaker, a menstrual poetry slam, and an art exhibit, as well as academic papers, the conference promises to be a lively antidote to the usual under-the radar treatment of menstrual issues.  Paper proposals for the conference are due January 16.  The SMCR website provides the following information about the conference:

Join us for a multidisciplinary and global conference to strengthen our research, activism, clinical service, artistic expression, and policy. We are working to achieve empowerment and social justice for women and girls everywhere by heightening menstrual health awareness, education, and services.

Menstrual health is central to women’s ability to lead lives of dignity and well being in every society and every part of the world. Without menstrual health other core rights remain in jeopardy. In fact, the UNDP and UNICEF have highlighted menstruation as “the single most important factor affecting school drop-out among girls” (2007), impeding the educational attainment that would facilitate social empowerment and financial independence around the globe. Yet, menstrual health is rarely respected, protected, or fulfilled as a human right, and has not been recognized or theorized as a reproductive justice issue.

“Stigma around menstruation and menstrual hygiene is a violation of several human rights, most importantly of the right to human dignity, but also of the right to non-discrimination, equality, bodily integrity, health, privacy, and the right to freedom from inhumane and degrading treatment from abuse and violence.”

Dr. Jyoti Sanghera, Office of the High Commissioner for Human Rights

We are now accepting abstracts—of no more than 500 words—describing papers, posters, workshops, panels or creative presentations. Proposals addressing all aspects of the menstrual cycle (physiological, sociocultural, psychological, or cross-cultural)  from menarche to menopause are encouraged, including those that involve research, theory, public policy, health care, and clinical applications, art, and activism. The possibilities are endless. Suggested topics intersect menstrual health and politics at any stage of the lifespan.  Download the submission guidelines and forms here! Deadline is January 16, 2015.  

January 14, 2015 in Health, Women's Rights | Permalink | Comments (2)

Tuesday, March 4, 2014

Bringing a Human Rights Approach to Those Living with HIV

On February 28 and March 1 HIV attorneys, activists and researchers gathered in Atlanta for the biannual HIV conference sponsored by the ABA’s Aids Coordinating Committee.  With 55% of women living with HIV reporting that they experienced intimate partner abuse and with women experiencing a high rate of HIV infection, this year’s conference focused on Women and HIV. This theme has been the focus of committee Chair Dawn Siler Nixon’s tenure.   Since the last conference there has been more attention paid to girls and women living with HIV and their particular difficulties.  In September, 2013, the Interagency Federal Working Group issued its report addressing the intersection of HIV/AIDS, Violence against Women and Girls & Gender-Related Health Disparities.   Among the disparities reported is the “higher rate of women, compared to men, of reporting subsequent impacts of violence on their lives, including posttraumatic stress disorder (PTSD) symptoms, injury, need for healthcare, and need for housing services.   One of the recommendations of the Working Group is for for a coordinated response between those who serve domestic violence survivors and those providing healthcare and other services to women living with HIV. A particular need for housing exists among both HIV positive women and domestic violence survivors.

A second and comprehensive report by the Positive Women’s Network  issued in November, 2013.  Unspoken: Sexuality, Romance, and Reproductive Freedom for Women Living with HIV in the United States.  The report covers what for many is new territory.  For example, when addressing reproductive freedom, the discussion is not simply on lack of availability or political underpinnings of choice, the report addresses sexual and emotional satisfaction in relationships.  In addition, the report discusses sexual and reproductive health for women living with HIV, the current epidemic among women as well as research results and the policy and legal environment for women living with HIV.  The report is rich in information and background research. 

One link between the conference and the PWN report is an emphasis on the  human rights of those living with HIV.  As the Positive Women’s report notes, US laws and policy “create a hostile environment for women living with HIV and have focused on preventing transmission at the expense of abridging the rights of women living with HIV to fulfill their sexual and reproductive rights.” In discussing these rights the report notes the relevance of the International Covenant on Civil and Political Rights (ICCPR),   the Convention on the Elimination of all forms of Discrimination Against Women (CEDAW) and the Convention on the Rights of Persons with Disabilities (CRPD).  I suggest that the foundational Universal Declaration of Human Rights  be considered and used as a tool for advancing the lives of women living with HIV and  with the co-occurrence of intimate partner abuse.  The goal of the human rights approach in addressing HIV and Domestic Violence is to restore dignity to those living with HIV.  Much more will be written on this topic in future blogs as the implementation of a Human Rights approach when working with individuals living with HIV is rich and varied, as documented in the Positive Women’s Network report.

 

March 4, 2014 in Health, Margaret Drew, Sexuality | Permalink | Comments (0)